LINCOLN — Murlene Nollmeyer Osburn likes to tell people there's dirt in her veins — from the sugar beet farm in eastern Montana where she grew up to the Sandhills ranch she now calls home near the Cherry County village of Wood Lake.
"We are so isolated, but I love it that way," Osburn said.
But much as she loves her rural home, with its wide-open vistas of newly mown hay meadows and fall-born calves, so also is she passionate about her newly earned opportunity to bring mental health services to a desperately underserved area.
In addition to being a rancher, Osburn, 53, is a registered nurse who earned a master's degree last year from a federal grant-funded University of Nebraska Medical Center program to train psychiatric nurse practitioners as a way to bring mental health services to rural Nebraska counties, the overwhelming majority of which have no practicing psychiatrists.
Psychiatric nurse practitioners can diagnose mental disorders, from schizophrenia to common depression, work with children who have ADHD, provide counseling and help patients manage what Osburn calls "head meds."
To Osburn, the need for mental health services in rural areas is deeply personal. Two incidents in the fall of 2009 motivated her interest in the UNMC program.
That October, Osburn recalled, her best friend in Wyoming committed suicide. The woman was in an abusive relationship and talked to Osburn for two hours before killing herself. "It was her good-bye phone call," Osburn said.
The following month, a neighbor's wife, who had suffered from schizophrenia for years, died, despite her husband's efforts to get help.
And Osburn herself knows what it's like to deal with mental health issues.
One of her sons was killed in a 1997 accident on the Montana sugar beet farm where she lived with her first husband. She also knows firsthand what it was like to live with an abusive second husband, whom she subsequently divorced.
Osburn finished her master's degree in December 2012, passed the required state test and is waiting for her new psychiatric nurse practitioner credentials to arrive in the mail. When they do, she'll be in uncharted territory.
She envisions essentially starting her own business, perhaps spending a day in Bassett, another in Ainsworth and another in Valentine, seeing patients and visiting area nursing homes.
For people who live in the Sandhills, the nearest psychiatrists are in Kearney and Hastings, and patients might have to wait two years for an appointment, Osburn said, adding: "No psychiatrist is ever going to practice here. You need people like us . . . to fill the need."
Psychiatric nurse practitioners, like all advanced practice nurses, are required under Nebraska law to have what amounts to a contract with a collaborating physician, which can cost up to $2,000 a month, Osburn said, a challenge she and a colleague in O'Neill are exploring.
Another barrier to mental health care in rural places is the nature of rural people themselves, whose sense of independence and pride in their strength of character often makes them reluctant to acknowledge mental health issues.
One way to overcome that reluctance, Osburn said, "is by talking about it, being frank about my own struggles."
Rural health is just one of the topics that will be discussed during breakout sessions at the Rural Futures Conference that will be conducted Nov. 3-5 in Lincoln at The Cornhusker.
People are encouraged to register soon before the conference venue reaches capacity. Visit ruralfutures.nebraska.edu/conference.